In his first edition of Allgemeine Psychopathologie (1913), Karl Jaspers looked upon psychotherapy as a kind of art, with the personality of the psychotherapist being the main factor of effectiveness. According to Jaspers, those personalities turn out to be good psychotherapists who have natural authority, that means, who have developed a capability to make decisions on the basis of instinctive conviction rather than by scientific reasoning. A further valuable predisposition is that a good psychotherapist has a philosophical outlook towards the other as someone “being in his world”, the notion of world being understood as an integration of a subject’s inner and outer world. Consistent with modern knowledge of the significance of good matching between patient and therapist, Jaspers already claimed: “He (the psychotherapist) is usually only good for a certain circle of people for whom he is well suited” (Jaspers 1997, p. 809). For Jaspers, psychotherapy is the attempt to help the invalid by means of psychic communication, so that he¹ can explore his inner world in its depths. This process enables the patient to retrieve degrees of freedom, not in an instrumental sense but by providing him with perspective (Schlimme et al. 2012). Consequently, the psychotherapist has characteristics of a philosopher, and successful psychotherapy is regarded as a process of clarification that results in an individual becoming himself (“das philosophierende Selbstwerden”; Jaspers 1973, p. 668). Following Jaspers, at best psychotherapy becomes an existential communication between companions in fate.

As indications of psychotherapy, Jaspers listed psychopathies or, personality disorders, mild psychoses, and all “subjects who feel ill and suffer from their psychic state” (Jaspers 1997, p. 835). Probably due to his own weak physical condition, he also recognized physical illnesses as indicators for the need of psychotherapy assuming that they are often overlaid with neurotic symptoms. Against the backdrop of his time, he differentiated the following methods of psychotherapy: suggestion, cathartic methods for after-effects of experiences sometimes bringing forgotten events to consciousness, autogenic training and other relaxation techniques, and re-education (including a precise structuring of daily life). Regarding methods that specifically address personality he suggested psychoeducation, rational methods of persuasion, appeals to will-power, as well as ways of understanding the contradictions between the conscious personality and his own unconscious motives. In a narrow sense, psychotherapy was restricted to the highest level of medical treatment and was differentiated from technical-causal treatment, dietetical treatment inspiring self-help, and educative treatment, which aimed at changing the patient’s lifestyle.

The following contribution searches for methodological sources in Jaspers’ work that may inspire our current perspectives on psychotherapy and the diagnostic process that precedes it. It was Jaspers who claimed that insight into the methodological confinement of psychotherapeutic methods and knowledge needs to be a basic competence of psychotherapists.

Within today’s concept of psychotherapy diagnostics is not a static, temporally limited procedure but a dynamic process. It is further needed for the primary case formulation that precedes commitment to a treatment plan and that later subsumes additional information that has been collected through therapeutic steps (Freyberger and Caspar 2007). With increasing dissemination of disorder-oriented methods of psychotherapy during the last decades, diagnostics have even gained in importance, starting from the detailed descriptive assessment of psychopathological symptoms that then leads to a nosologic diagnosis or to several diagnoses (i.e. comorbidities). This approach is supplemented by a functional-behavioral analysis or related concepts in psychodynamic psychotherapy that illuminate each facet of the patient’s problem and take various domains of inner processing into consideration, such as cognitions, emotions, behavior, and physiology. Beyond these steps, the diagnostic process includes further characteristics of the patient: his concept of illness and treatment, strength of motivation to change, resources and impediments of change, degree of self-awareness and self-reflection (whether the patient can take a stance towards himself and recognizes motives for his behavior), and—of particular importance—capabilities such as interpersonal competence, reality testing, self-regulation, and self-identity, which reflect the level of structure functioning (Herpertz et al. 2012). In addition, the complex structure of motives and conflicts between them have to be detected, or to use Grawe’s language of plan analysis (1998), the inconsistencies have to be identified that are induced by discordancies among motivational schemata, respectively, aims of approach and avoidance and/or incongruencies with actual life experiences.